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utility and benefits of gathering data for
funders, clients, & clinic or
consumer operated programs (COSPs)
14th Annual Summer Institute
Michael S. Shafer & Vicki L. Staples
ASU Center for Applied Behavioral Health Policy
Suzanne Legander
Stand Together And Recover Centers, Inc.
Our
Agenda
Defining Consumer
Operated Service Programs
What is STAR and Why Did
We Contract with ASU?
Challenges & Lessons
Learned in Data Collection
Data, Data, Data
Making Use of the Data &
Next Steps
Defining Consumer Operated
Service Programs
Defining Consumer Operated Service Programs (COSPs)
5 Core Features
Independent Owned, administratively controlled, and managed by mental health consumers
Autonomous All decisions are made by the program
Accountable Responsibility for decisions rests with the program
Consumer controlled
Governance board is at least 51% mental health consumers
Peer workers Staff and management are people who have received mental health services
Peer service agencies
Peer services
Peer support programs
Consumer-run organizations
Consumer-Operated Service
Program (COSP)
Community Service Agency (CSA)
• Build Community
• Facilitate Mutual Aid/Mutual Support
• Advocate
• Provide Services & Support
What Do COSPs Do?
COSPs Provide A Variety of Services Drop In Center
Assistance with Basic Needs or Benefits
Social & Recreational Opportunities
Arts & Expression
Information & Referral Crisis Response & Respite
Structured Educational & Support Groups
Peer Counseling
The Evidence Base for COSPs
Use problem-centered coping skills
Use more coping strategies
Achieve more education
Score higher in social functioning
Express more hopefulness and self-efficacy
Individuals attending COSPS were found to:
"Consumer-Run Service Participation, Recovery of Social Functioning, and the Mediating Role of Psychological Factors." Yanos, P.T., Primavera, L.H., Knight, E. (2001). Psychiatric Services, 52(4), 493-500.
The Evidence Base for COSPs
Participation in Consumer-Operated Services increases sense of overall well-being by building
hope, empowerment, and social connectedness.
– Higher participation leads to greater increase in sense of well-being.
– Positive effects are not limited to one program type or model.
Do not have preconceived notions
that a consumer-operated service
should look or operate like a
mental health center.
It won’t….It shouldn’t
STARTED IN 1984 AT MARICOPA COUNTY PSYCHIATRIC ANNEX Officially Incorporated 1986
1st Location purchased with support from St. Luke's and Triple R
Current – 3 Locations, Main Program, Young Adult Program, Fun Bunch, Catering
Measurable outcomes
Past 5 yrs Federal and state legislature proposals for evidence-based practices
Accountability
Good steward of tax payer funds
Improve on what works
Reduced cost to the peer and community
I Identify and prioritize the goals, objectives and evaluation or research questions
II Literature review, create & match items for each outcome or evaluation/research question
III Create/establish a pool of items
IV Independent group of readers who review the items and determine face validity
V Pilot test the questionnaires
VI Create Scantron versions of questionnaires
Asking the right questions? Borrowing from some
existing tools What do Peer Recovery
Centers offer? Clear, Concise, Measurable,
Respecting Culture, Confidentiality, Duration
Testing the Tool
Characteristic of participants who utilized
peer-run recovery services
Which services are participants utilizing
at the recovery center? How often are they
using these services?
Are participants satisfied with the services
they use at the recovery center?
Are there differences (reduction or improvements)
in outcomes over time?
Are there differences in outcomes by participant
characteristics (e.g., gender, age, race/ethnicity,
education, income source, diagnoses, military
service, homelessness, involvement with law
enforcement)?
Are utilized services related to outcomes?
(Is frequency of service use related to outcomes?)
Anonymous & confidential self-report survey
Voluntary, recruitment occurs by STAR staff
Peer Recovery Center Intake Questionnaire (PRC-IQ)
Peer Recovery Center Quarterly Questionnaire (PRC-QQ)
0.0% 25.0% 50.0% 75.0%
Female
Military Service
White
Latino
African-Amrican
American Indian
49.1%
10.0%
65.8%
18.9%
10.8%
3.2%
0.00% 20.00% 40.00%
Dropped out before high …
Attended high school but …
High school diploma or …
Attended college but did …
College degree
9.80%
17.80%
33.90%
20.10%
18.40%
0% 40% 80%
Mood Disorder
Psychotic Disorder
Anxiety Disorder
Personality Disorder
SubAbuse/Dep
Other Disorder
73%
55%
56%
24%
14%
8%
0%
20%
40%
60%
80%
100%
Psych. Hosp.
Suicide Attempts
Arrested Jail/Prison Detox Homeless
86.50%
64.80% 60.60% 54%
25.80% 29%
Psych Hosp. Suicide Attempts
13.60%
35.20%
31.70%
40.50% 24.90%
11.00% 29.90%
13.30% 7 >
None
4 - 6
1 – 3
“S.T.A.R. has saved my life. Very caring, loving, and
down to earth people. And they shoot from the hip.”
0%
10%
20%
30%
40%
Less than 3 months
More than 3 months but less
than 1 year
1-2 years Over 2 years
33.5%
15.4% 14.0%
37.1%
“I feel so grateful, happy,
excited coming to S.T.A.R.
I'm making friends, staff and
participants are kind,
empathetic + compassionate
caring also. Thank you for
having this program available.”
0%
4%
8%
12%
16%
Baseline
1st f/u
“By going to the budgeting group here at S.T.A.R. I have been able to save for things that been long range financial goals.”
0%
5%
10%
15%
20%
Employed Volunteer Job Training
GED College
Baseline 1st f/u
Quarterly Follow ups
View of Peer’s Own Health Compared to General Public
Existing Initial Membership Info Gathering – Impact on Data
Need for Staff Training on Survey Administration
Fear of Consequences
Tracking for Follow ups
Staff assisting peers with reading and writing difficulties
Scantron errors
Educating and Building Trust with Members
Meeting Up with STAR Members to Share Overall Data
More Peers are Answering Substance Use Questions
Suicide Attempt Info
Send all staff to ASIST training
More Choice of Services
Trained more staff on benefits education
Program Changes at STAR
Develop Collaborations with primary care physicians
Making partnerships with Health Plans
More Whole Health Education
ILS Cooking Classes
Educating the Public and Legislature - dispelling myth
Family Nights
WRAP Classes
Data Shows Significant Reduction in Crisis Utilization
Revised Peer Recovery Center Intake & Quarterly Questionnaire (PRC-IQ/QQ)
Spanish version
Ability for longer term tracking and participant characteristics comparisons on outcomes
Compare with other COSPs both locally and nationally
Self report vs. service utilization (PRC data with RBHA encounters)